I. Anatomy of the Respiratory System A. Upper Respiratory System Structures 1. Nose a. External Nares (Nostrils) 1) Vestibule Stratified Squamous Epithelium b. Nasal Cartilages 1) Nasal Cavity Pseudostratified Ciliated Columnar Epithelium a) Nasal Septum b) Nasal Conchae 1] Superior for Olfactory Reception 2] Mucous membrane on Superior, Middle, and Inferior a] Warm, Moisten & Filter Air c) Meatuses d) Paranasal Sinuses 1] Resonance for Speech e) Hard palate f) Soft palate 1] Uvula g) Internal Nares (Choanae)
2. Pharynx a. Nasopharynx - Pseudostratified Ciliated Columnar Epithelium 1) Internal Nares (Posterior Nasal Aperture) 2) Auditory Tubes (Eustachian or Pharyngotympanic) a) Tubule Tonsils 3) Pharyngeal Tonsil (Adenoid) b. Oropharynx Nonkeratinized Stratified Squamous Epithelium 1) Fauces 2) Palatine Tonsils 3) Lingual Tonsil c. Laryngopharynx (Hypopharynx) Nonkeratinized Stratified Squamous Epithelium
B. Lower Respiratory System 1. Larynx a. Cartilages Most are Hyaline Cartilage 1) Epiglottis Elastic Cartilage* 2) Thyroid Cartilage (Adam s apple) 3) Cricoid Cartilage 4) Arytenoid Cartilages paired 5) Corniculate Cartilages paired 6) Cuneiform Cartilages paired b. Laryngeal Ligaments 1) Thyrohyoid Ligament 2) Cricothyroid Ligament 3) Cricotracheal Ligament 4) Superior Vestibular Ligament 5) Inferior Vocal Ligament c. Glottis 1) Vestibular Folds (False Vocal Cords) 2) Vocal Folds (True Vocal Cords)
2. Trachea a. Pseudostratified Ciliated Columnar Epithelium b. Tracheal Cartilages Incomplete Hyaline Cartilage Rings (C-shaped) c. Trachealis Muscle Smooth Muscle d. Elastic Connective Tissue e. Carina 3. Bronchial Tree branching ~ 23 times before lobule a. Extrapulmonary Bronchi (Medial to Lungs) 1) Right & Left Primary (Main) Bronchi b. Intrapulmonary Bronchi (Within Lungs) 1) Secondary (Lobar) Bronchi 2) Tertiary (Segmental) Bronchi 3) Bronchioles Smaller Divisions a) Terminal Bronchioles 1] Conducting Zone Structures (Anatomical Dead Space) 2] Respiratory Bronchioles Simple Squamous Epithelium a] Respiratory Zone Structures b] Alveolar Ducts
4. Lungs a. Pleural Membrane 1) Parietal Pleura 2) Visceral Pleura 3) Pleural Cavity b. Surface Features 1. Apex 2. Base 3. Costal Surface 4. Cardiac Notch (Impression) 5. Hilum c. Lobes 1) Right Lung Human 3, Cat 4 a) Superior Right Lobe 1] Horizontal Fissure b) Middle Right Lobe 1] Oblique Fissure c) Inferior Right Lobe 2) Left Lung Human 2, Cat 3 a) Superior Left Lobe 1] Oblique Fissure b) Inferior Left Lobe
3) Bronchopulmonary Segments area served by Tertiary Bronchus a) Lobules area served by Terminal Bronchiole 1] Alveoli a] Grouped into Alveolar Sacs b] Epithelium [1] Type I Alveolar Cells (Simple Squamous Epithelium) [2] Type II Alveolar Cells (Septal Cells) [a] Surfactant [3] Alveolar Macrophages (Dust Cells) c] Respiratory Membrane (Air-Blood Barrier) [1] Pulmonary Capillaries [a] Endothelium [b] Basal Lamina 5. Clinical Application: Asthma a. Treated with Bronchodilator drugs, such as Albuterol
II. Physiology of the Respiratory System A. Phases of Respiration 1. Pulmonary Ventilation (Breathing) a. Inspiration (Inhalation) b. Expiration (Exhalation) 2. External (Pulmonary) Respiration a. Transport of Respiratory Gases in Bloodstream 3. Internal (Tissue) Respiration a. Cellular Respiration Metabolism B. Mechanics of Respiration 1. Pulmonary Ventilation a. Average Respiratory Rate is 12 breaths per minute b. Pressure Differences (Gradient) 1) Atmospheric Pressure a) 760 mm Hg at Sea level (15 psi) 2) Intrapulmonic Pressure c. Boyle s Law: The pressure of a gas in a closed container is inversely proportional to the volume of the container.
d. Inspiration Active Process 1) Diaphragm 2) External Intercostal muscles 3) Atmospheric Pressure > Intrapulmonic Pressure e. Expiration Passive Process at Rest 1) Muscles Relax 2) Elastic Recoil 3) With Exercise Expiration becomes Active a) Internal Intercostal muscles b) Abdominal muscles 4) Atmospheric Pressure < Intrapulmonic Pressure
2. Lung Volumes and Capacities Spirometry a. Spirometer 1) Wet Spirometer 2) Dry Spirometer, Handheld, or Windmill Type b. Tidal Volume (TV) 500 ml (350 ml reaches alveoli) 1) Anatomical Dead Space 2) Physiological Dead Space c. Inspiratory Reserve Volume (IRV) 3300 ml Males, 1900 ml Females d. Expiratory Reserve Volume (ERV) 1000 ml Males, 700 ml Females e. Vital Capacity (VC) 4800 ml Males, 3100 ml Females 1) VC = IRV + TV + ERV 2) Predicted Vital Capacity (PVC) (H=height, A=age) a) Males: PVC = 0.052H 0.022A 3.60 b) Females: PVC = 0.041H 0.018A 2.69 f. Residual Volume (RV) 1200 ml Males, 1100 ml Females g. Minimal Volume 30 120 ml in collapsed lungs h. Total Lung Capacity (TLC) 6000 ml Males, 4200 ml Females 1) TLC = VC + RV i. Respiratory Rate (RR) j. Minute Volume (MV) 1) MV = TV X RR
3. Clinical Application a. Emphysema 4. Respiratory Sounds Auscultation with Stethoscope a. Bronchial Sounds http://faculty.etsu.edu/arnall/www/public_html/heartlung/breathsounds/contents.html b. Vesicular Breathing Sounds http://www.med.ucla.edu/wilkes/lungintro.htm c. Triangle of Auscultation 1) Rales or Crackles 2) Wheezing